Drug Facts Week Interview: Huda Akil

Today marks the beginning of the National Institute on Drug Abuse’s National Drug Facts Week, a health observance week for teens that aims to shatter the myths about drug abuse. In past years, the Dana Foundation blog has featured interviews with Dana Alliance members who are addiction experts, and this year is no different. DABI member Huda Akil, Ph.D., the co-director of the Molecular and Behavioral Neuroscience Institute at the University of Michigan, talked about how the difficulty in conquering addiction varies.

“Addiction is not just about willpower,” she said. “Much of how our brains and bodies react to drugs is out of our control. The lack of predictability about how your body is going to respond should be one of biggest reasons why people don’t play with that fire.”

It’s a similar suggestion to what Rob Malenka told us last year: The only sure-fire way to avoid addiction and its accompanying problems is to avoid substance abuse. “Kids need to understand that just because someone did drugs and lived to tell about it doesn’t mean it will be that way for the majority.”

Akil is working to understand why that’s the case. She points to a host of reasons—an individual’s history, the circumstances under which they get exposed to drugs, as well as genetic, biological, and developmental factors. She said that, when on drugs, different peoples’ brains look similar. But the long-term consequences of a drug may be different in different brains. Some will have a lot more difficulty breaking the addiction than others. “Some of our work shows that the way your brain was before the drug affects what your brain does after the drug.”

Akil talked about thrill- or sensation-seeking people and more conservative individuals. Both are good for a society: without the former, there would be fewer discoveries and advancements; without the latter, dangerous situations could become catastrophic. But people at the extreme end of the more adventurous group are more likely to try drugs.

Akil and her research team can predict, based on genetic background alone, whether a rat will be thrill-seeking and, if so, whether it’s more likely to relapse after addiction. But these genetic tendencies can be modified: “We can give them a molecule which moves them towards the middle [of the adventurous spectrum]. I’m not saying it’s good or bad, but their sense of adventure and willingness to try drugs can be dialed up or down with early-life manipulations. It’s much more complicated in humans. Unlike rats, most humans approach the situation knowing that drugs of abuse have consequences on their brain and behavior. In some individuals, that knowledge is sufficient to inhibit their novelty seeking; in others it’s not.”

She believes there will be a cure to prevent and/or treat addiction in her lifetime. “I don’t think it will be a one-size-fits-all cure. It will require an understanding of the context of drug abuse for the individual. The more we understand about the underlying biology and its interaction with other factors, the more we’re likely to help. Finding the right way to fine-tune that knowledge is totally attainable.”

Of course, as Akil reminds us, “The best way to prevent addiction is not to take drugs to begin with.”